Sickle Cell Care Expansion Act of 2023

I 118TH CONGRESS 1ST SESSION H. R. 3100 To amend the Public Health Service Act to authorize a scholarship and loan repayment program to incentivize physicians to enter into the field of sickle cell disease research, treatment, and patient care, and for other purposes. IN THE HOUSE OF REPRESENTATIVES MAY 5, 2023 Ms. LEE of California (for herself and Mr. DAVIS of Illinois) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to authorize a scholarship and loan repayment program to incentivize physicians to enter into the field of sickle cell disease research, treatment, and patient care, and for other pur- poses. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Sickle Cell Care Ex- 4 pansion Act of 2023’’. 5 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 3100 IH SEC. 2. ADVANCING TREATMENT AND RESEARCH PER- 1 TAINING TO SICKLE CELL DISEASE. 2 Part D of title III of the Public Health Service Act 3 (42 U.S.C. 254b et seq.) is amended by adding at the end 4 the following: 5 ‘‘Subpart XIII—Advancing Treatment and Research 6 Pertaining to Sickle Cell Disease 7 ‘‘SEC. 340J. SCHOLARSHIP AND LOAN REPAYMENT PRO- 8 GRAM. 9 ‘‘(a) IN GENERAL.—To advance learning regarding 10 sickle cell disease and to enhance the supply of physicians 11 to treat such disease, especially with respect to adult popu- 12 lations, the Secretary, acting through the Administrator 13 of the Health Resources and Services Administration, 14 shall carry out a program consisting of entering into con- 15 tracts with individuals under which— 16 ‘‘(1) the Secretary awards a scholarship under 17 subsection (b) or agrees to make loan repayments 18 under subsection (c) with respect to each individual; 19 and 20 ‘‘(2) the individual agrees to serve for a period 21 (in this section referred to as the ‘period of obligated 22 service’) as a physician engaged in— 23 ‘‘(A) sickle cell disease research; or 24 ‘‘(B) service in a public or private setting 25 that is primarily focused on treatment and edu- 26 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 3100 IH cation related to sickle cell disease in a health 1 care facility, clinic, rural health clinic, mobile 2 medical asset, or other facility as determined by 3 the Secretary. 4 ‘‘(b) SCHOLARSHIPS.— 5 ‘‘(1) ELIGIBILITY.—To be eligible to participate 6 in the scholarship program under this section, an in- 7 dividual shall— 8 ‘‘(A) be accepted for enrollment, or be en- 9 rolled, as a full-time student in an accredited 10 (as determined by the Secretary) educational 11 institution in a State and in a course of study 12 or program offered by such institution and ap- 13 proved by the Secretary, leading to a degree in 14 medicine or osteopathic medicine; 15 ‘‘(B) submit an application to participate 16 in the scholarship program; and 17 ‘‘(C) sign and submit to the Secretary, at 18 the time of submittal of such application, a 19 written contract (described in paragraph (2)) to 20 accept payment of a scholarship and to serve 21 (in accordance with this section) for the appli- 22 cable period of obligated service. 23 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 3100 IH ‘‘(2) WRITTEN CONTRACT.—The written con- 1 tract under this subsection between the Secretary 2 and an individual shall contain— 3 ‘‘(A) an agreement that— 4 ‘‘(i) subject to paragraph (1), the Sec- 5 retary agrees to provide the individual with 6 a scholarship in each such school year or 7 years for a period of years (not to exceed 8 four school years) determined by the indi- 9 vidual, during which period the individual 10 is pursuing a course of study described in 11 paragraph (1)(A); and 12 ‘‘(ii) subject to paragraph (1), the in- 13 dividual agrees to— 14 ‘‘(I) accept provision of such a 15 scholarship to the individual; 16 ‘‘(II) maintain enrollment in a 17 course of study described in para- 18 graph (1)(A) until the individual com- 19 pletes the course of study; 20 ‘‘(III) maintain an acceptable 21 level of academic standing; 22 ‘‘(IV) complete a residency in a 23 specialty that the Secretary deter- 24 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 5 •HR 3100 IH mines is consistent with pursuit of a 1 fellowship in hematology; 2 ‘‘(V) complete a fellowship in the 3 specialty of hematology; and 4 ‘‘(VI) serve for a time period 5 equal to one year for each school year 6 for which the individual was provided 7 a scholarship under this section; 8 ‘‘(B) a provision that any financial obliga- 9 tion of the United States arising out of the con- 10 tract and any obligation of the individual which 11 is conditioned thereon, is contingent upon funds 12 being appropriated for scholarships under this 13 section; 14 ‘‘(C) a statement of the damages to which 15 the United States is entitled if the individual 16 should breach the contract; and 17 ‘‘(D) such other statements of the rights 18 and liabilities of the Secretary and of the indi- 19 vidual as the Secretary determines appropriate, 20 not inconsistent with the provisions of this sec- 21 tion. 22 ‘‘(c) LOAN REPAYMENTS.— 23 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 6 •HR 3100 IH ‘‘(1) ELIGIBILITY.—To be eligible to participate 1 in the loan repayment program under this section, 2 an individual shall— 3 ‘‘(A) have a degree in medicine or osteo- 4 pathic medicine; be enrolled in an approved 5 graduate training program in medicine or osteo- 6 pathic medicine; or be enrolled as a full-time 7 student in an accredited (as determined by the 8 Secretary) educational institution in a State, 9 and in the final year of a course of study of- 10 fered by such institution and approved by the 11 Secretary, leading to a degree in medicine or 12 osteopathic medicine; 13 ‘‘(B) submit an application to participate 14 in the loan repayment program; and 15 ‘‘(C) sign and submit to the Secretary, at 16 the time of submittal of such application, a 17 written contract (described in paragraph (2)) to 18 accept payment by the Secretary of the edu- 19 cational loans of the individual in consideration 20 of the individual serving for a period of obli- 21 gated service. 22 ‘‘(2) WRITTEN CONTRACT.—The written con- 23 tract under this subsection between the Secretary 24 and an individual shall contain— 25 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 7 •HR 3100 IH ‘‘(A) an agreement that— 1 ‘‘(i) subject to paragraph (1), the Sec- 2 retary agrees to pay on behalf of the indi- 3 vidual the principal, interest, and related 4 expenses on government and commercial 5 loans received by the individual regarding 6 the undergraduate or graduate education 7 of the individual (or both), which loans 8 were made for— 9 ‘‘(I) tuition expenses; 10 ‘‘(II) all other reasonable edu- 11 cational expenses, including fees, 12 books, and laboratory expenses, in- 13 curred by the individual; or 14 ‘‘(III) reasonable living expenses 15 as determined by the Secretary; and 16 ‘‘(ii) subject to paragraph (1), the in- 17 dividual agrees to— 18 ‘‘(I) accept loan payments on be- 19 half of the individual; 20 ‘‘(II) maintain enrollment in a 21 course of study described in para- 22 graph (1)(A) (if applicable) until the 23 individual completes the course of 24 study; 25 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 8 •HR 3100 IH ‘‘(III) maintain an acceptable 1 level of academic standing; 2 ‘‘(IV) complete a residency in a 3 specialty that the Secretary deter- 4 mines is consistent with pursuit of a 5 fellowship in hematology; and 6 ‘‘(V) complete a fellowship in he- 7 matology; 8 ‘‘(B) a provision that any financial obliga- 9 tion of the United States arising out of the con- 10 tract and any obligation of the individual which 11 is conditioned thereon, is contingent upon funds 12 being appropriated for loan repayments under 13 this section; 14 ‘‘(C) a statement of the damages to which 15 the United States is entitled if the individual 16 should breach the contract; and 17 ‘‘(D) such other statements of the rights 18 and liabilities of the Secretary and of the indi- 19 vidual as the Secretary determines appropriate, 20 not inconsistent with the provisions of this sec- 21 tion. 22 ‘‘(d) PRIORITY.—In awarding contracts under this 23 section for scholarships and loan repayments, the Sec- 24 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 9 •HR 3100 IH retary may prioritize making awards to individuals from 1 disadvantaged backgrounds. 2 ‘‘(e) DEFINITION.—In this section, the term ‘sickle 3 cell disease research’ means research into the detection, 4 diagnosis, treatment, or control of sickle cell disease. 5 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 6 carry out this section, there is authorized to be appro- 7 priated $150,000,000 for each of fiscal years 2024 8 through 2029. 9 ‘‘SEC. 340J–1. COMMUNITY-BASED GRANTS TO ENGAGE THE 10 SICKLE CELL DISEASE POPULATION BY DE- 11 SIGNING EDUCATION AND ADVOCACY PRO- 12 GRAMS AND POLICIES FOR HEALTH AND 13 COMMUNITY SERVICES. 14 ‘‘(a) IN GENERAL.—The Secretary shall carry out a 15 program consisting of awarding grants to eligible entities 16 for the establishment and support of education and advo- 17 cacy programs that engage the sickle cell disease popu- 18 lation, their families, or State and local governments in 19 order to— 20 ‘‘(1) improve sickle cell disease health literacy, 21 including mental health awareness and educational 22 attainment; 23 ‘‘(2) disseminate information on health and 24 community services related to sickle cell disease; or 25 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 10 •HR 3100 IH ‘‘(3) improve access to care and treatment deci- 1 sion-making processes related to sickle cell disease. 2 ‘‘(b) APPLICATIONS.—To seek a grant under sub- 3 section (a), an eligible entity shall submit an application 4 to the Secretary at such time, in such manner, and con- 5 taining such information and assurances as the Secretary 6 may require. 7 ‘‘(c) CONSIDERATION.—In determining whether to 8 award a grant under this section to an applicant, and the 9 amount of a grant under this section, the Secretary shall 10 consider the need for sickle cell education or services in 11 the area to be served using the grant. 12 ‘‘(d) DEFINITION.—In this section, the term ‘eligible 13 entity’ means— 14 ‘‘(1) a community-based organization or faith- 15 based organization or clinic that provides services to, 16 or engages in, advocacy for individuals with sickle 17 cell disease; 18 ‘‘(2) a nonprofit organization providing com- 19 prehensive care to populations with sickle cell dis- 20 ease, including any such nonprofit organization that 21 is a faith-based organization or community-based or- 22 ganization; or 23 ‘‘(3) a Federally qualified health center (as de- 24 fined in section 1861(aa) of the Social Security Act) 25 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 11 •HR 3100 IH or nonprofit organization engaged in providing sickle 1 cell disease education, information, or treatment 2 services. 3 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 4 carry out this section, there is authorized to be appro- 5 priated $50,000,000 for each of fiscal years 2024 through 6 2029. 7 ‘‘SEC. 340J–2. GRANTS FOR SICKLE CELL DISEASE PEDI- 8 ATRIC TO ADULT TRANSITIONS OF CARE. 9 ‘‘(a) IN GENERAL.—The Secretary shall carry out a 10 program of awarding grants to eligible entities for the es- 11 tablishment and support of programs— 12 ‘‘(1) that— 13 ‘‘(A) provide transition support through a 14 dedicated transition coordinator and manage- 15 ment of care for sickle cell disease patients be- 16 tween the ages of 18 and 29 who are aging out 17 of pediatric care and receiving adult care for 18 sickle cell disease; 19 ‘‘(B) assist sickle cell patients in identi- 20 fying and maintaining adult primary care pro- 21 viders and adult specialists for sickle cell dis- 22 ease compatible with the patient’s health insur- 23 ance; and 24 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 12 •HR 3100 IH ‘‘(C) provide support services, including 1 mental health services, for the management of 2 the patient’s treatments and medical appoint- 3 ments throughout the transition to adult care; 4 and 5 ‘‘(2) which, in the case of an eligible entity that 6 is a hospital or an institute of higher education, may 7 include providing training to adult sickle cell disease 8 care specialists on the medical needs of young sickle 9 cell disease patients, through— 10 ‘‘(A) 1- to 2-year long fellowships for any 11 individual that has completed a residency in 12 medicine, combined internal medicine and pedi- 13 atrics, or family medicine; or 14 ‘‘(B) short-term programs and workshops. 15 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 16 a grant under this section, an entity shall— 17 ‘‘(1) be a nonprofit organization providing com- 18 prehensive care to populations with sickle cell dis- 19 ease, including a hospital or an institute of higher 20 education, and including any such nonprofit organi- 21 zation that is a faith-based organization or commu- 22 nity-based organization; and 23 ‘‘(2) submit an application to the Secretary at 24 such time, in such manner, and containing such in- 25 VerDate Sep 11 2014 00:48 May 13, 2023 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H3100.IH H3100 kjohnson on DSK79L0C42PROD with BILLS 13 •HR 3100 IH formation and assurances as the Secretary may re- 1 quire. 2 ‘‘(c) CONSIDERATION.—In determining whether to 3 award a grant under this section to an eligible entity, and [Text truncated for display. Full text available on Congress.gov.]